Transform’s response to the ACMD’s review of ecstasy operates at two levels. At one level, in the short term at least, we welcome the review as a long overdue response to the many calls(1) for the seemingly anomalous classification of ecstasy to be reviewed. From Transform’s perspective any reduction in unjust criminal penalties for consenting adult drug users is a positive step. At a more profound level, however, we remain deeply concerned that regardless of alphabetic classification, ecstasy will remain illegal, its users will still be subject to serious criminal sanctions, and the control of its production and supply will remain in the hands of unregulated criminal profiteers.

Over the past ten years Transform has argued that the absolute prohibition of drugs in the face of sustained demand inevitably leads to the creation of illicit markets that not only maximise the dangers of drugs for their users but also create a raft of secondary harms to society relating to the organized criminal networks and unregulated dealers who control the trade. There is no evidence that punitive law and its enforcement has anything other than, at best, a marginal impact on levels of drug use or misuse(2) despite the fact that the deterrent effect of the laws’ enforcement is nominally at the heart of the entire prohibitionist model. The model is unique in the public health field in deploying criminal sanctions to reduce social and health harms. It is also uniquely ineffective.

Ecstasy provides an instructive example, its use exploding in the late 80’s from almost zero in 1985 to around 2 million pills being consumed every weekend by the end of the decade, peaking in the 90’s and then falling gradually since the turn of the millennium. During this entire period ecstasy use was Class A and enforcement has not changed significantly. The recent decline in ecstasy use appears to be due to shifting youth culture, with the rise in cocaine use (also Class A for the entire period) evidently filling the void. How ecstasy is classified has been largely irrelevant but, Transform argues, the fact that it is classified within the MDA at all has had profound and dangerous implications. It is hard to imagine any scenario under which harms could be maximised further, and as such any recommendation for ecstasy’s classification maintains its absolute prohibition within the MDA and effectively perpetuates prohibition’s role in maximizing the harms associated with its production, supply and use.

This briefing explores the problems evaluating the harms of illicit ecstasy use, as well as the opportunity such a review presents to compare harms associated with illicit and licit use. It also considers the extraordinary political environment in which policy responses to ecstasy have emerged, and the Government’s unashamed anti-science posturing on the issue.

It concludes that any review of the harm of ecstasy, or indeed any illegal drug, is essentially pointless if no distinction is made between harms caused by the drug and those created and or exacerbated by its illegality. Transform has been calling for the ACMD to work at disaggregating policy harms from drug harms for some years now, maintaining that the ACMD’s continued explicit support for the criminalisation of drug production, supply and use (and failure to explore alternative regulatory options) makes them part of the problem instead of being part of the solution. Given the dramatic failure of the existing system and its appalling negative consequences (in both public health and criminal justice arenas) it is absolutely imperative that the ABC classification system itself, and the legislative framework of the MDA 1971 in which it sits, is the subject of the Advisory Council’s expert scrutiny.

Conclusions and recommendations

In the short term, if the current review finds, as widely expected, that ecstasy is inappropriately classified in Class A then, in the context of the existing system, a recommendation for reclassification to B or C should be made.

The ACMD’s report should also take the opportunity to make a clear recommendation for adequate resources to be put into targeted education about MDMA/ecstasy risks/harms and how they can be minimised/avoided.

It is vital that the review report takes the opportunity to make a clear distinction between harms relating to MDMA toxicity specifically, and harms relating to use of ‘ecstasy’ when it is produced, supplied and consumed illicitly.

Highlighting this important distinction between drug harms and harms created or exacerbated by policy will inevitably prompt a discussion of whether legally regulated production and availability of MDMA (obviously combined with the removal of all criminal sanctions for consenting adult users) would deliver better criminal justice and public health outcomes. The ACMD, as an independent voice of expertise should not shy away from such a discussion, however hysteria-inducing it may be in certain sections of Whitehall or the tabloid media. Indeed it is absolutely appropriate that the ACMD consider such matters in line with their remit to consider “restricting the availability of such drugs or supervising arrangements for their supply”, and the ACMD’s recent recommendation that "the current arrangements to control the supply of illegal drugs should be reviewed to determine whether any cost-effective and politically acceptable measures can be taken to reduce their availability to young people"(3).

The ecstasy review, however, is a distraction from the fundamental flaws with the classification system outlined above (and in more detail in the appended paper). It is unconscionable for the ACMD to simply proceed with a systematic review of classification of all drugs covered under the MDA (which, at the current rate will take many years to complete) when there is simply no evidence that an ABC system for determining a hierarchy of criminal penalties produces positive public health outcomes, and a substantial amount to demonstrate it is actively counterproductive and harmful.

It is of paramount importance that the ACMD assert the primacy of a scientific approach not only in terms of producing first class reviews of individual drug harms but also in terms of evaluating the policy impacts of ACMD recommendations, their implementation, and the system within which they operate. This is specifically in reference to the evidential and ethical basis for an ABC drug harm ranking system rooted within punitive criminal justice legislation.

Transform, therefore, hope that the appointment of a new ACMD chair will provide a fresh opportunity for the ACMD to instigate the long overdue root and branch review of the entire classification system; its aims and objectives, its outcomes on key indicators, and the legislative and institutional structures within which it operates.

Such a review was promised by the Home Secretary in the House of Commons in 2006(4), but despite a review consultation paper being fully drafted and ready for dissemination, the review was abruptly cancelled when a new Home Secretary was appointed. Such a review was supported by the Science and Technology Select Committee, the ACMD itself and, to the best of our knowledge, everyone in the drugs field. The absurd reason given by the Home Office for this review being cancelled was that ‘The Government believes that the classification system discharges its function fully and effectively and has stood the test of time’(5).

The ACMD cannot stand idly by whilst the Government so blatantly prioritises its own political posturing over rational policy evaluation and review, and dismisses a scientific approach on the basis of entirely un-evidenced ‘beliefs’. That such political games interfere with reclassification recommendations is beside the point (there is no evidence classification changes have any impact anyway). The more significant danger is that a policy infrastructure that has been such a manifest failure for over three decades remains unchallenged, perpetuating systemic failure and in a very real sense, costing lives.

The ACMD should demand of the Government that the classification review process be re-instigated with some urgency, and failing this undertake or commission such a review themselves.

1 comment:

steve, very lovely and direct! i so appreciate your efforts, they make a difference! redirecting the ACMD to their remit time and time again is the way. sir michael finally admitted to palad.org.uk only a few weeks ago that their duty includes the review of the function and performance of the MDA and to advise on any exercise of the powers provided in it and on any changes in 'any' law, which may be necessary to achieve the MDA's harm reduction aims, including the UN conventions! let us continue to be in action towards a rational and objective policy which implements the MDA without discrimination based on historical and cultural factors having nothing to do with harm reduction and everything to do with pandering to the electoral majority and their scapegoat strategy! fiat lux! freecasey.org

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